11D2175426 CLIA NUMBER - WALMART PHARMACY 10-920

Laboratory Demographics

CLIA Number: 11D2175426

Facility Name: WALMART PHARMACY 10-920

Facility Address:
3009 RUSSELL PARKWAY
WARNER ROBINS, GA
ZIP 31088
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Facility Phone Number: 478 333-7026

Facility Type: Pharmacy

Certificate Type: Waiver

NPI Number: 1487033973

Taxonomy: 3336C0003X - Pharmacy
A pharmacy where pharmacists store, prepare, and dispense medicinal preparations and/or prescriptions for a local patient population in accordance with federal and state law; counsel patients and caregivers (sometimes independent of the dispensing process); administer vaccinations; and provide other professional services associated with pharmaceutical care such as health screenings, consultative services with other health care providers, collaborative practice, disease state management, and education classes.

CLIA Record

Field Name	Field Value
CLIA Number	11D2175426
LAB Type	Pharmacy
Facility Name	WALMART PHARMACY 10-920
Street	3009 RUSSELL PARKWAY
City	WARNER ROBINS
State	GA
ZIP	31088
Phone	478 333-7026
CertificateType	4
CertificateEffectiveDate	11/20/2023
CertificateExpirationDate	11/19/2025
FacilityType	Waiver

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This page was last updated on: 4/23/2024